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General NPI Number Information
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NPI Number | 1962931170
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Entity Type | Individual
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Provider Name | LIA MARIE MICELI MD
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Gender | Female
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 09/22/2024
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Provider Practice Location Address
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Address Line | 4815 LIBERTY AVE STE GR50
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City | PITTSBURGH
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State | PA
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Zip | 15224-2156
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Country | US
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Telephone | 412-578-1212
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Fax | 412-605-6467
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Provider Business Mailing Address
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Address Line | 4815 LIBERTY AVE STE GR50
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City | PITTSBURGH
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State | PA
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Zip | 15224-2156
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Country | US
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Telephone | 412-578-1212
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Fax | 412-605-6467
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | MD486714
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 57030472
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License Number State | OH
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